AMENDMENT TO THE AGREEMENTConfidential
AMENDMENT TO THE AGREEMENT BETWEEN
AMERICAN HEALTHWAYS SERVICES, LLC AND
CITY OF CLEARWATER
EFFECTIVE APRIL 1, 2016
This document serves as an Amendment to the Healthways Provider Agreement (the "Agreement ") between
AMERICAN HEALTHWAYS SERVICES, LLC ( "Healthways "), and CITY OF CLEARWATER ( "Facility ").
For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties
hereby amend the Agreement as follows.
1. The Agreement shall be amended such that Momingside Recreation Complex shall be added as an Amenities
Only participating location attached herein as an additions to Exhibit A, effective April 1, 2016.
a) There shall be no Minimum Payment Guarantee for services provided at the Momingside Recreation
Complex location.
2. Except as expressly modified by this Amendment, the Agreements and any previously signed amendments or
addenda shall remain in full force and effect.
3. The individual signing below on behalf of Facility represents and warranties that he /she has all requisite
corporate power and authority to enter into this Amendment on behalf of Facility.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to be effective as of April 1, 2016.
AMERICAN HEALTHWAYS SERVICES, LLC CITY OF CLEARWATER
a Delaware corporation
ignature �,
well
Chief Operating Officer, Network Solutions,
See 4-143e,) Sivvc
Signature
Printed Name
Title
Date Date
FL/17701/50410
Page 1 of 3
City Signature Page for
Amendment to the Agreement between
American Healthways Services, LLC and
City of Clearwater
Effective March 1, 2016
Countersigned:
George N. Cretekos
Mayor
Approv-d as to form:
CITY OF CLEARWATER, FLORIDA
By: L 8
William B. Home, II
City Manager
Attest:
Matt ew M. Smith f-or: R•semarie Ca II
Assistant City Attorney
City Clerk
Confidential
EXHIBIT A -1
AMENITIES ONLY FACILITY INFORMATION
The information in the box below is intended for marketing purposes. Please confirm that it is accurate
Facility Name:
Physical Address:
Phone Number:
Web Site Address:
Morningside Recreation Complex
2400 Ham Boulevard
Clearwater, FL 33764
(727) 507-4065
www.myclearwater.com
*To enable marketing of amenities and services are marketed, please designate your basic amenities below and all
amenities upon initial log in to the Fitness Provider Portal.
Amenity/Program
X
Offered as part of basic membership at
no additional cost to Members
Cardiovascular Equipment
Group Exercise /Aerobics Area
Hot Tub/Whirlpool
Resistance Training Equipment
Steam and/or Sauna
Swimming Pool — Seasonal (not available throughout the year)
Swimming Pool — Year -Round
Fax:
General Email:
Who will be our primary location contact (Healthways Program Advisor)? This individual will be responsible for
scheduling training, coordinating with our Provider Services Liaison, and will need access to member records.
Contact Person:
Contact Title:
( ) O Direct Fax O Need to call first
Contact Phone: ( )
Contact Fax: ( )
Contact Email:
Mailing Address (f not the same as Physical Address):
Mailing Address:
Shipping Address (if not the same as Physical Address):
Shipping Address:
FL/17701/50410
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I
Confidential
Staffed Hours of Operation
1
Are Members able to access Facility during unstaffed hours? O No O Yes
What non - English languages does staff speak fluently? Please list:
Please select one location type:
O Men and women
O Women only
O Men only
FL /17701 /50410
Page 3 of 3
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Open
Closed
Are Members able to access Facility during unstaffed hours? O No O Yes
What non - English languages does staff speak fluently? Please list:
Please select one location type:
O Men and women
O Women only
O Men only
FL /17701 /50410
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